Gargouri Rahma, Fenina Wafa, Al Juaidi Mohamed, Feki Walid, Fendri Hela, Msaed Sameh, Moussa Nedia, Mnif Zeineb, Kammoun Samy
Pulmonology department, Hedi Chaker university hospital, Faculty of Medicine of Sfax. Sfax University.
Pulmonology department, Hedi Chaker university hospital, Faculty of Medicine of Tunis. University of Tunis Manar.
Sarcoidosis Vasc Diffuse Lung Dis. 2024 Dec 10;41(4):e2024060. doi: 10.36141/svdld.v41i4.15747.
Sarcoidosis is a systemic disease of unknown cause characterized by the formation of non-caseating granulomatous inflammation in various organs, mainly lungs and intrathoracic lymph nodes. Its clinical and paraclinical presentation can vary from mild to life-threatening. Our objective is to study the clinical, paraclinical and evolution profile of mediastino-pulmonary sarcoidosis.
This is a retrospective, descriptive and analytic study conducted over a 20-year period (January 2002 to December 2022). It compiled records of patients who were followed up for confirmed mediastino-pulmonary sarcoidosis.
The study included 35 patients with a mean age of 56.69 ± 14.42 . There was a clear predominance of female patients, with a male-to-female sex ratio of 0.346. The most common functional respiratory signs were dyspnea (82.9%) and dry cough (80%). Extra-respiratory symptoms were noted in 45.7% of cases, with the most common being polyarthralgia (28.6%), xerophthalmia (20%) and xerostomia (14.3%). The most common parenchymal lesions were micronodules (71.4%), nodules (51.4%), and peribronchovascular thickening (40%). The The right upper lobe (77.1%) and middle lobe (74.3%) were the most affected lobes. Hilar adenopathy (71.4%), paratracheal adenopathy (60%), and the aorto-pulmonary window (54.3%) were the most frequent lymph node involvements. Respiratory function tests revealed a restrictive ventilatory defect in 32% of cases and an obstructive ventilatory defect in 13% .Oral corticosteroids were initially administered in 60% of cases. Chronic respiratory failure was observed in 20% of cases. Factors significantly associated with an unfavorable outcome included hemoptysis (p=0.008), the need for corticosteroid treatment (p=0.009), Acute respiratory failure (p=0.05), and echographic dilation of the right cavities (p=0.002).
The clinical phenotype of sarcoidosis can be extremely diverse.Thoracic computed tomography plays an important role in the diagnosis and monitoring of the disease. The evolution of sarcoidosis is variable and depends on the occurrence of complications.
结节病是一种病因不明的全身性疾病，其特征是在各个器官，主要是肺和胸内淋巴结形成非干酪样肉芽肿性炎症。其临床和辅助检查表现可从轻微到危及生命不等。我们的目的是研究纵隔-肺结节病的临床、辅助检查及病情演变情况。
这是一项为期20年（2002年1月至2022年12月）的回顾性、描述性和分析性研究。它收集了确诊为纵隔-肺结节病患者的随访记录。
该研究纳入了35例患者，平均年龄为56.69±14.42岁。女性患者明显居多，男女比例为0.346。最常见的功能性呼吸体征是呼吸困难（82.9%）和干咳（80%）。45.7%的病例出现了呼吸外症状，最常见的是多关节痛（28.6%）、干眼症（20%）和口干症（14.3%）。最常见的实质性病变是微小结节（71.4%）、结节（51.4%）和支气管血管周围增厚（40%）。右上叶（77.1%）和中叶（74.3%）是受影响最严重的叶。肺门淋巴结肿大（71.4%）、气管旁淋巴结肿大（60%）和主动脉-肺动脉窗（54.3%）是最常见的淋巴结受累情况。呼吸功能测试显示32%的病例存在限制性通气功能障碍，13%的病例存在阻塞性通气功能障碍。60%的病例最初使用了口服糖皮质激素。20%的病例观察到慢性呼吸衰竭。与不良预后显著相关的因素包括咯血（p=0.008）、需要糖皮质激素治疗（p=0.009）、急性呼吸衰竭（p=0.05）和右腔室超声扩张（p=0.002）。
结节病的临床表型可能极其多样。胸部计算机断层扫描在该疾病的诊断和监测中起着重要作用。结节病的病情演变是可变 的，取决于并发症的发生情况。
